Two-step retrograde closed stenting: a novel method for treating canalicular lacerations in Chinese patients

Abstract

Purpose To evaluate the efficacy of two-step retrograde closed stenting for treating canalicular laceration. Methods Forty-eight consecutive canalicular laceration cases (48 eyes) were randomised and divided into two groups: a one-step group and a two-step group. In the two-step group (23 cases), the first step was performed in the outpatient department and included identifying the medial cut end of the canaliculus and probing under a slit-lamp microscope, followed by a retrograde canalicular stenting assisted by a memory titanium stylet. The second step was canalicular anastomosis, which was performed in the operating room. In the one-step group (25 cases), all of the surgical procedures were performed when preoperative preparations were simultaneously available. Results The time elapsed from the doctor visit to the treatment was 4.3 ± 2.4 h in the two-step group and 18.8±6.3 h in the onestep group (Po0.01). The canalicular medial cut ends were found in all cases, but 8.6 ± 3.5 min was needed in the two-step group, and 51.4±24.2 min was needed in the one-step group (Po0.01). The numerical rating scale for pain during surgery was 1.8 ± 1.2 in the two-step group and 5.4 ± 2.2 in the one-step group (Po0.01). One case (2.63%) in the two-step group and nine cases (36%) in the one-step group required other assisted methods to locate the medial cut end (P ¼ 0.007). Twenty-one cases (91.3%) in the two-step group and 20 cases (80%) in the one-step group achieved patent lacrimal drainage systems during a 12-month follow-up (P ¼ 0.528). ConclusionsThe two-step canalicular anastomosis method allows an early search for the medial cut end of the canaliculus and improves the chances of finding it; it is also a quicker, less invasive method for treating canalicular lacerations.

Eiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation

“…Canalicular laceration, which is commonly regarded as an ocular emergency, is caused by trauma on the eyelids and in periorbital areas. It frequently involves the lower canaliculus and its incidence has been reported in all age groups [1]. Canalicular lacerations are present in approximately 16% of all eyelid lacerations due to ocular trauma [2].…”

Management of Traumatic Lower-Eyelid Avulsion and Complete Loss of the Lacrimal Canaliculus: A Case Report

“…In comparison to the bicanalicular method, it avoids iatrogenic injury to the other uninjured part of the lacrimal drainage system. Many published papers describe surgical techniques for traumatic canalicular reconstruction when tissue is preserved [14, 15, 16, 17, 18, 19, 20, 21, 22]. However, there are only few reports about the reconstruction of a lost non-preserved canaliculus [5, 23].…”

The etiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation

“…Canalicular laceration is commonly regarded as ocular emergency, caused by trauma in the eyelids and periorbital areas, frequently involving the lower canaliculus, have been reported in all age groups 1 . They are present in approximately 16% of all eyelid lacerations due to ocular trauma 2 .…”